Service de Biochimie, Assistance Publique-Hôpitaux de Paris, Hôpital Charles-Foix, Ivry-sur-Seine, France.
Clin Endocrinol (Oxf). 2011 Sep;75(3):315-20. doi: 10.1111/j.1365-2265.2011.04047.x.
Despite malnutrition being a major problem in hospitalized elderly patients, there is a lack of studies focusing on the comparative value of biological parameters for monitoring renutrition. The aim of this study was to determine which biological parameter(s) could best monitor successful renutrition in hospitalized malnourished elderly patients.
The objective of the study was to explore the impact of a 6-week renutrition process on anthropometric and biological parameters in elderly patients and to define the biological parameters associated with weight regain.
A total of 72 hospitalized malnourished elderly patients admitted to a hospital-based geriatric rehabilitation unit.
Patients were evaluated at admission and at 6 weeks for anthropometric measurements of weight, sum of the four subcutaneous skinfold thicknesses, calf circumference and biological serum parameters including albumin, transthyretin, leptin, IGF-1, IGFBP-1 and IGFBP-3. Renutrition was considered successful if a patient gained at least 5% of body weight over 6 weeks.
Leptin was the only biological parameter that increased at 6 weeks in successful renutrition. Leptin variations were not influenced by C-reactive protein variations, in contrast to transthyretin which can be modified by the inflammatory states frequently encountered in geriatric patients.
Serum leptin is a more appropriate parameter than transthyretin for monitoring renutrition.
尽管营养不良是住院老年患者的一个主要问题，但缺乏专门针对生物参数监测再营养状况的研究。本研究旨在确定哪些生物参数可以最好地监测住院营养不良老年患者的再营养成功情况。
本研究旨在探讨 6 周再营养过程对老年患者人体测量和生物参数的影响，并确定与体重恢复相关的生物参数。
共纳入 72 名住院营养不良的老年患者，他们被收治于一家医院老年康复病房。
患者在入院时和 6 周时接受评估，进行体重、四个皮下皮褶厚度总和、小腿周长和生物血清参数（包括白蛋白、转甲状腺素、瘦素、IGF-1、IGFBP-1 和 IGFBP-3）的人体测量测量。如果患者在 6 周内体重增加至少 5%，则认为再营养成功。
在再营养成功的患者中，只有瘦素在 6 周时增加。瘦素的变化不受 C 反应蛋白变化的影响，而转甲状腺素则可能受到老年患者常见的炎症状态的影响。
血清瘦素是监测再营养状况比转甲状腺素更合适的参数。
